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Botelho BJS, Brito WRDS, Pereira Neto GDS, Gonçalves JSS, Oliveira BMS, de Oliveira CMC, de Lima ACR, Lima SS, Pinheiro PDNQ, Freitas FB, Guerreiro JF, Ishak R, Vallinoto ACR, Cayres Vallinoto IMV. Molecular and Phylogenetic Evidence of Interfamilial Transmission of HTLV-1 in the Afro-Descendant Community of São José de Icatú in the Brazilian Amazon. Viruses 2024; 16:1290. [PMID: 39205264 PMCID: PMC11360191 DOI: 10.3390/v16081290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 07/27/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024] Open
Abstract
This study aimed to describe the prevalence of HTLV-1/2 in quilombola communities in the state of Pará and investigate the possible sociodemographic risk factors associated with the infection, as well as to trace the occurrence of the familial transmission of the virus. A total of 310 individuals living in eight quilombos located in the state of Pará (northern Brazil) were investigated for the presence of anti-HTLV-1/2 antibodies using an enzyme-linked immunosorbent assay (ELISA), and positive samples were confirmed using Western blot and/or real-time quantitative polymerase chain reaction (qPCR). Participants answered a questionnaire about sociodemographic aspects and risk factors for infection. Anti-HTLV-1/2 antibodies were detected in two individuals (one man and one woman), for an overall seroprevalence of 0.65%. Both individuals belonged to the community of São José de Icatú. The search for intrafamilial infection identified two other infected women, which increased the general prevalence of HTLV-1 among the Icatú to 6.25% (4/64). Western blot and qPCR confirmed their HTLV-1 infection, and phylogenetic analysis demonstrated that the isolates were of the cosmopolitan subtype and transcontinental subgroup. Epidemiological investigation of the cases revealed that the three women, at some point in their lives, had a relationship with the infected male individual. HTLV-1 is transmitted silently between individuals in the community of São José de Icatú with a present or past family relationship, stressing the need for screening and laboratory diagnosis to prevent further dissemination of the virus and surveillance of disease emergence.
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Affiliation(s)
- Bruno José Sarmento Botelho
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Wandrey Roberto dos Santos Brito
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Gabriel dos Santos Pereira Neto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Janete Silvana Souza Gonçalves
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Bruna Maria Silva Oliveira
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Camille Marcela Camarinha de Oliveira
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | | | | | - João Farias Guerreiro
- Human and Medical Genetics Laboratory, Federal University of Pará, Belém 66075-110, Pará, Brazil;
| | - Ricardo Ishak
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Izaura M. Vieira Cayres Vallinoto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
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O'Donnell JS, Jaberolansar N, Chappell KJ. Human T-lymphotropic virus type 1 and antiretroviral therapy: practical considerations for pre-exposure and post-exposure prophylaxis, transmission prevention, and mitigation of severe disease. THE LANCET. MICROBE 2024; 5:e400-e408. [PMID: 38246188 DOI: 10.1016/s2666-5247(23)00359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 01/23/2024]
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus associated with substantial risk of secondary (often life-threatening) disease for the estimated 10 million to 20 million people infected globally. Despite a clear need, no HTLV-1-specific vaccine or antiretroviral therapy has been developed to date. Instead, existing public and primary health-care interventions inadequately focus on infection prevention and management of secondary diseases. In this Personal View, we discuss the evidence that exists to support the sensitivity of HTLV-1 to antiretroviral therapies approved by the US Food and Drug Administration for the treatment of HIV-1, how this sensitivity is affected by clinically relevant virological and immunological features, and additional practical considerations for the use of antiretroviral therapies in the context of HTLV-1.
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Affiliation(s)
- Jake S O'Donnell
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia; The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia.
| | - Noushin Jaberolansar
- The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia
| | - Keith J Chappell
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia; The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia; Australian Infectious Disease Research Centre, The University of Queensland, St Lucia, QLD, Australia
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3
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O'Donnell JS, Hunt SK, Chappell KJ. Integrated molecular and immunological features of human T-lymphotropic virus type 1 infection and disease progression to adult T-cell leukaemia or lymphoma. Lancet Haematol 2023; 10:e539-e548. [PMID: 37407143 DOI: 10.1016/s2352-3026(23)00087-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 07/07/2023]
Abstract
The human T-lymphotropic virus type 1 (HTLV-1) retrovirus infects 10-20 million people globally, with endemic regions in southwestern Japan, the Caribbean basin, Africa, and central Australia. HTLV-1 is associated with lifelong infection and immune suppression, resulting in a range of serious sequalae, including adult T-cell leukaemia or lymphoma (ATLL) in 5% of cases. To date, there are no preventive or curative treatments for HTLV-1 and treatment outcomes for ATLL remain generally poor. Depending on the disease subtype, overall survival is 8-55 months. Recent advancements in the past decade have identified genetic, molecular, and immunological events occurring throughout the lives of individuals infected with HTLV-1 and of those who progress to ATLL. In addition, updated guidelines for clinical management have been published. With the aim of focusing research efforts on the development of treatments for both HTLV-1 infections and ATLL, we have conceptualised a four-step disease model for HTLV-1-associated ATLL: (1) viral exposure, (2) establishment of chronic infection, (3) cellular transformation and evolution, and (4) disease presentation and management. For each stage we describe the clinical features, molecular and immunological factors involved, potential biomarkers of disease progression, and the therapeutic applicability of individual targets. We also discuss emerging concepts and novel treatment approaches. Our hope is that this model will promote research interest and guide the testing of new treatments for this neglected virus and its associated rare cancer.
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Affiliation(s)
- Jake S O'Donnell
- School of Chemistry and Molecular Biosciences, and the Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia.
| | - Stewart K Hunt
- Department of Haematology and Bone Marrow Transplant, Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Keith J Chappell
- School of Chemistry and Molecular Biosciences, and the Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia; Australian Infectious Disease Research Centre, The University of Queensland, St Lucia, QLD, Australia
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Dixon L, McNamara C, Dhasmana D, Taylor GP, Davies N. Imaging Spectrum of HTLV-1–Related Neurologic Disease. Neurol Clin Pract 2023; 13:e200147. [PMID: 37066106 PMCID: PMC10092304 DOI: 10.1212/cpj.0000000000200147] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/23/2023] [Indexed: 03/29/2023]
Abstract
Purpose of ReviewHuman T-cell lymphotropic virus type 1 (HTLV-1)–associated myelopathy (HAM) is a well-recognized neurologic complication of HTLV-1. Beyond HAM, several other neurologic manifestations are increasingly recognized, including acute myelopathy, encephalopathy, and myositis. The clinical and imaging features of these presentations are less well understood and potentially underdiagnosed. In this study, we summarize the imaging features of HTLV-1–related neurologic disease, providing both a pictorial review and pooled series of the less well-recognized presentations.Recent Findings35 cases of acute/subacute HAM and 12 cases of HTLV-1–related encephalopathy were found. In subacute HAM, cervical and upper thoracic longitudinally extensive tranverse myelitis was noted, while in HTLV-1–related encephalopathy, confluent lesions in the frontoparietal white matter and along the corticospinal tracts were the most prevalent finding.SummaryThere are varied clinical and imaging presentations of HTLV-1–related neurologic disease. Recognition of these features aids early diagnosis where therapy may have the greatest benefit.
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Affiliation(s)
- Luke Dixon
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Cillian McNamara
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Divya Dhasmana
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Graham P Taylor
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Nicholas Davies
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
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Kannampuzha S, Gopalakrishnan AV, Padinharayil H, Alappat RR, Anilkumar KV, George A, Dey A, Vellingiri B, Madhyastha H, Ganesan R, Ramesh T, Jayaraj R, Prabakaran DS. Onco-Pathogen Mediated Cancer Progression and Associated Signaling Pathways in Cancer Development. Pathogens 2023; 12:770. [PMID: 37375460 DOI: 10.3390/pathogens12060770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Infection with viruses, bacteria, and parasites are thought to be the underlying cause of about 8-17% of the world's cancer burden, i.e., approximately one in every five malignancies globally is caused by an infectious pathogen. Oncogenesis is thought to be aided by eleven major pathogens. It is crucial to identify microorganisms that potentially act as human carcinogens and to understand how exposure to such pathogens occur as well as the following carcinogenic pathways they induce. Gaining knowledge in this field will give important suggestions for effective pathogen-driven cancer care, control, and, ultimately, prevention. This review will mainly focus on the major onco-pathogens and the types of cancer caused by them. It will also discuss the major pathways which, when altered, lead to the progression of these cancers.
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Affiliation(s)
- Sandra Kannampuzha
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India
| | - Hafiza Padinharayil
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680596, India
| | - Reema Rose Alappat
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680596, India
- Post Graduate and Research Department of Zoology, Maharajas College, Ernakulam 682011, India
| | - Kavya V Anilkumar
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680596, India
- Post Graduate and Research Department of Zoology, Maharajas College, Ernakulam 682011, India
| | - Alex George
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680596, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata 700073, India
| | - Balachandar Vellingiri
- Stem Cell and Regenerative Medicine/Translational Research, Department of Zoology, School of Basic Sciences, Central University of Punjab (CUPB), Bathinda 151401, India
| | - Harishkumar Madhyastha
- Department of Cardiovascular Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan
| | - Raja Ganesan
- Institute for Liver and Digestive Diseases, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Thiyagarajan Ramesh
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
| | - Rama Jayaraj
- Jindal Institute of Behavioral Sciences (JIBS), Jindal Global Institution of Eminence Deemed to Be University, Sonipat 131001, India
- Director of Clinical Sciences, Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
| | - D S Prabakaran
- Department of Radiation Oncology, College of Medicine, Chungbuk National University, Chungdae-ro 1, Seowon-gu, Cheongju 28644, Republic of Korea
- Department of Biotechnology, Ayya Nadar Janaki Ammal College, Srivilliputhur Main Road, Sivakasi 626124, India
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Yeo S, Yang L, Ong K, Yong TT. Breastfeeding With Infectious Diseases. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221123395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aims: Human breast milk remains an important source of protection against infection, inflammation, allergy and long-term metabolic disorders for the breastfed offspring. During cases of ongoing infection, the dilemma faced by both medical health professionals and mothers is the need to balance the risk of continuing versus temporarily or permanently ceasing to breastfeed. The aim of our article is to review existing literature regarding breastfeeding during acute infectious and non-infectious illnesses and to provide feasible evidence-based suggestions which can be implemented by medical practitioners during counselling of breastfeeding mothers. Method: A literature search was conducted on PubMed (US National Library of Medicine) using various combinations of keywords related to breastfeeding and the various infections. The citations from all selected articles were reviewed for additional studies. Results: Most ongoing infections are not contraindications for breastfeeding, with the exceptions of Human Immunodeficiency viruses (HIV), Human T-cell lymphotropic virus (HTLV) types 1 and 2. Even with HIV, there is increasing evidence to reassure that with adequate antiretroviral therapy, breastfeeding is likely to be safe. Of particular concern during the COVID-19 pandemic too, current evidence indicates that mothers with COVID-19 infection can safely breastfeed, and therefore initiation and continuation of breastfeeding should continue to protect the health of the babies and mothers. Conclusion: During this pandemic especially, there is a strong and urgent need to support mothers with acute infections who wish to breastfeed. With better awareness, physicians can play an important role in securing positive experiences for breastfeeding mothers and optimizing infant outcomes.
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Affiliation(s)
- Samantha Yeo
- Singapore Health Services, KK Women's and Children's Hospital, Singapore
| | - Liying Yang
- Singapore Health Services, Singapore General Hospital, Singapore
| | - Kirsten Ong
- Singapore Health Services, KK Women's and Children's Hospital, Singapore
| | - Tze Tein Yong
- Singapore Health Services, Singapore General Hospital, Singapore
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Tu JJ, Maksimova V, Ratner L, Panfil AR. The Past, Present, and Future of a Human T-Cell Leukemia Virus Type 1 Vaccine. Front Microbiol 2022; 13:897346. [PMID: 35602078 PMCID: PMC9114509 DOI: 10.3389/fmicb.2022.897346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) is an oncogenic human retrovirus which causes a lifelong infection. An estimated 5-10 million persons are infected with HTLV-1 worldwide - a number which is likely higher due to lack of reliable epidemiological data. Most infected individuals remain asymptomatic; however, a portion of HTLV-1-positive individuals will develop an aggressive CD4+ T-cell malignancy called adult T-cell leukemia/lymphoma (ATL), or a progressive neurodegenerative disease known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Few treatment options exist for HAM/TSP outside of palliative care and ATL carries an especially poor prognosis given the heterogeneity of the disease and lack of effective long-term treatments. In addition, the risk of HTLV-1 disease development increases substantially if the virus is acquired early in life. Currently, there is no realistic cure for HTLV-1 infection nor any reliable measure to prevent HTLV-1-mediated disease development. The severity of HTLV-1-associated diseases (ATL, HAM/TSP) and limited treatment options highlights the need for development of a preventative vaccine or new therapeutic interventions. This review will highlight past HTLV-1 vaccine development efforts, the current molecular tools and animal models which might be useful in vaccine development, and the future possibilities of an effective HTLV-1 vaccine.
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Affiliation(s)
- Joshua J. Tu
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Victoria Maksimova
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States
| | - Lee Ratner
- Division of Molecular Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Amanda R. Panfil
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States
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Itabashi K, Miyazawa T. Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention. Cancers (Basel) 2021; 13:cancers13164100. [PMID: 34439253 PMCID: PMC8394315 DOI: 10.3390/cancers13164100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/29/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 95% of mother-to-child transmission (MTCT) of human T-cell leukemia virus type-1 (HTLV-1) is derived from prolonged breastfeeding, which is a major cause of adult T-cell leukemia (ATL). Exclusive formula feeding (ExFF) is therefore generally used to prevent MTCT. A recent cohort study revealed that 55% of pregnant carriers chose short-term breastfeeding for ≤3 months in Japan. Our meta-analysis showed that there was no significant increase in the risk of MTCT when breastfeeding was carried out for ≤3 months compared with ExFF (pooled relative risk (RR), 0.72; 95% confidence interval (CI), 0.30-1.77), but there was an almost threefold increase in risk when breastfeeding was carried out for up to 6 months (pooled RR, 2.91; 95% CI, 1.69-5.03). Thus, short-term breastfeeding for ≤3 months may be useful in preventing MTCT. Breastmilk is the best nutritional source for infants, and any approach to minimizing MTCT by avoiding or limiting breastfeeding must be balanced against the impact on the child's health and mother-child bonding. To minimize the need for nutritional interventions, it is necessary to identify factors that predispose children born to carrier mothers to MTCT and thereby predict MTCT development with a high degree of accuracy.
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Affiliation(s)
- Kazuo Itabashi
- Aiseikai Memorial Ibaraki Welfare Medical Center, 1872-1 Motoyoshida-cho, Mito-City 310-0836, Japan
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
- Correspondence: ; Tel.: +81-29-353-7171; Fax: +81-29-353-6112
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
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Ghaffari-Rafi A, Rho YS, Hall A, Villanueva N, Nogi M. HTLV-1 associated acute adult T-cell lymphoma/leukemia presenting as acute liver failure in Micronesian: A case report. Medicine (Baltimore) 2021; 100:e26236. [PMID: 34260522 PMCID: PMC8284719 DOI: 10.1097/md.0000000000026236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/19/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Malignant infiltration accounts for 0.5% of acute liver failure cases, with non-Hodgkin's lymphoma the predominant cause. Adult T-cell lymphoma/leukemia (ATLL) is a rarer source of acute hepatitis, with only 3 cases reported and all resulting in immediate deterioration with death. ATLL rises from human T-lymphocytic virus-1 (HTLV-1), commonly found in Japan (southern and northern islands), the Caribbean, Central and South America, intertropical Africa, Romania, and northern Iran. In Micronesia, HTLV-1 infection amongst native-born is absent or exceedingly rare. PATIENT CONCERNS A 77-year-old Marshallese man presented to the emergency department with a 1-week history of generalized weakness, fatigue, and nausea. The physical exam revealed a cervical papulonodular exanthem and scleral icterus. DIAGNOSIS Laboratory studies were remarkable for aspartate-aminotransferase of 230 IU/L (reference range [RR]: 0-40), alanine-aminotransferase of 227 IU/L (RR: 0-41), alkaline phosphatase of 133 IU/L (RR: 35-129), and total bilirubin of 4.7 mg/dL (RR: 0-1.2), supporting acute liver injury. Platelet count was 11.6x104/μL (RR: 15.1-42.4 × 104), hemoglobin was 13.8 g/dL (RR: 13.7-17.5), and white blood cell count was 7570/μL (RR: 3800-10,800) with 81.8% neutrophils (RR: 34.0-72.0) and 10.4% lymphocytes (RR: 12.0-44.0). The peripheral blood smear demonstrated abnormal lymphocytes with occasional flower cell morphology. HTLV-1/2 antibody tested positive. The skin and liver biopsies confirmed atypical T-cell infiltrate. The diagnosis of ATLL was established. INTERVENTIONS The patient elected for palliative chemotherapy with cyclophosphamide, vincristine, and prednisone (CVP). He began antiviral treatment with zidovudine 250 mg bis in die (BID) indefinitely. Ursodiol and cholestyramine were added for his hyperbilirubinemia. OUTCOMES Four weeks from admission, the patient returned to near baseline functional status and was discharged home. LESSONS This case highlights that ATLL can initially present as isolated acute hepatitis, and how careful examination of peripheral blood-smear may elucidate hepatitis etiology. We also present support for utilizing ursodiol with cholestyramine for treating a hyperbilirubinemia. Moreover, unlike prior reports of ATLL presenting as liver dysfunction, combined antiviral and CVP chemotherapy was effective in this case. Lastly, there are seldom demographic reports of HTLV-1 infection from the Micronesian area, and our case represents the first indexed case of HTLV-1-associated-ATLL presenting as acute liver failure in a Marshallese patient.
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Affiliation(s)
- Arash Ghaffari-Rafi
- University of California, Davis, School of Medicine, Department of Neurological Surgery Sacramento, CA
- University of Hawai’i at Mānoa, John A. Burns School of Medicine Honolulu, Hawaii
| | - Young Soo Rho
- University of Hawai’i at Mānoa, John A. Burns School of Medicine, Department of Medicine Honolulu, Hawaii
- The Queen's Medical Center Honolulu, Hawaii
| | - Andrew Hall
- The Queen's Medical Center Honolulu, Hawaii
- University of Hawai’i at Mānoa, John A. Burns School of Medicine, Department of Pathology Honolulu, Hawaii
| | - Nicolas Villanueva
- University of Hawai’i at Mānoa, John A. Burns School of Medicine, Department of Medicine Honolulu, Hawaii
- The Queen's Medical Center Honolulu, Hawaii
| | - Masayuki Nogi
- University of Hawai’i at Mānoa, John A. Burns School of Medicine, Department of Medicine Honolulu, Hawaii
- The Queen's Medical Center Honolulu, Hawaii
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Ahmadi Ghezeldasht S, Shamsian SAA, Gholizadeh Navashenaq J, Miri R, Ashrafi F, Mosavat A, Rezaee SA. HTLV-1 oncovirus-host interactions: From entry to the manifestation of associated diseases. Rev Med Virol 2021; 31:e2235. [PMID: 33742509 DOI: 10.1002/rmv.2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022]
Abstract
Human T lymphotropic virus type-1 (HTLV-1) is a well-known human oncovirus, associated with two life-threatening diseases, adult T cell leukaemia/lymphoma (ATL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). The study of this oncogenic virus is significant from two different aspects. First, HTLV-1 can be considered as a neglected public health problem, which may spread slowly worldwide. Second, the incidence of HTLV-1 associated diseases due to oncogenic effects and deterioration of the immune system towards autoimmune diseases are not fully understood. Furthermore, knowledge about viral routes of transmission is important for considering potential interventions, treatments or vaccines in endemic regions. In this review, novel characteristics of HTLV-1, such as the unusual infectivity of virions through the virological synapse, are discussed in the context of the HTLV-1 associated diseases (ATL and HAM/TSP).
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Affiliation(s)
- Sanaz Ahmadi Ghezeldasht
- Inflammation and Inflammatory Diseases Division, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ali Akbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | | | - Raheleh Miri
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | - Fereshteh Ashrafi
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases Division, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Dangana A, Abdullahi IN, Billyrose OMA, Emeribe AU, Abu JM, Anka AU, Animasaun OS, Ghamba PE. Sero-epidemiology of human T-cell lymphotropic viruses-1 and -2 infection among pregnant women attending Abuja Teaching Hospital, Nigeria. Hum Antibodies 2021; 29:101-108. [PMID: 33523048 DOI: 10.3233/hab-200435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is the paucity of HTLV-1/-2 studies on Nigerian pregnant women despite the medical and public health significance of maternal-to-child transmission of HTLV-1/-2. OBJECTIVE This study aims to determine the seroprevalence and risk factors of HTLV-1/-2 infections among pregnant women attending the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. MATERIALS AND METHODS Blood samples were collected from consented pregnant women and analysed for ant-HTLV-1/-2 total antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Pretested structured questionnaires were used to collate participants' socio-demographic variables and risk factors of HTLV infection. RESULTS Out of the 156 pregnant women tested for HTLV-1/-2 antibodies, 16 (10.3%) were seropositive. There was no significant association between the socio-demographic variables collated and seroprevalence of HTLV-1/-2 infection among pregnant women (p> 0.05). Pregnant women with HIV infection had a lower prevalence of HLTV-1/-2 infection than those without HIV infections (7.5% versus 11.7%). Pregnant women with multiple sexual partners had a higher risk of HTLV-1/-2 infection than those who had single (OR = 2.08, 95% CI: 0.53-8.18). Women with a history of needles injury had a higher risk of HTLV-1/-2 infection than those who do not (OR = 1.24, 95% CI: 0.38-4.08). The history of blood transfusion was significantly associated with HTLV-1/-2 infection (p= 0.027). However, no significant association existed between other risk factors of HTLV-1/-2 infection among pregnant women (p> 0.05). CONCLUSION Considering the 3% pooled national prevalence of HTLV-1/-2 infection in Nigeria, the seroprevalence reported in this study is relatively high. Thus, there is a need for more large cohort studies and routine screening of population at increased risk of infection.
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Affiliation(s)
- Amos Dangana
- Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Ahmadu Bello University, Zaria, Nigeria
| | | | - Anthony Uchenna Emeribe
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Joel Monday Abu
- Department of Family Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Abubakar Umar Anka
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Olawale Sunday Animasaun
- Nigeria Field Epidemiology and Laboratory Training Program, African Field Epidemiology Network, Abuja, Nigeria
| | - Peter Elisha Ghamba
- WHO National Polio Laboratory, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
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12
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Al Sharif S, Pinto DO, Mensah GA, Dehbandi F, Khatkar P, Kim Y, Branscome H, Kashanchi F. Extracellular Vesicles in HTLV-1 Communication: The Story of an Invisible Messenger. Viruses 2020; 12:E1422. [PMID: 33322043 PMCID: PMC7763366 DOI: 10.3390/v12121422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 02/08/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) infects 5-10 million people worldwide and is the causative agent of adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) as well as other inflammatory diseases. A major concern is that the most majority of individuals with HTLV-1 are asymptomatic carriers and that there is limited global attention by health care officials, setting up potential conditions for increased viral spread. HTLV-1 transmission occurs primarily through sexual intercourse, blood transfusion, intravenous drug usage, and breast feeding. Currently, there is no cure for HTLV-1 infection and only limited treatment options exist, such as class I interferons (IFN) and Zidovudine (AZT), with poor prognosis. Recently, small membrane-bound structures, known as extracellular vesicles (EVs), have received increased attention due to their potential to carry viral cargo (RNA and proteins) in multiple pathogenic infections (i.e., human immunodeficiency virus type I (HIV-1), Zika virus, and HTLV-1). In the case of HTLV-1, EVs isolated from the peripheral blood and cerebral spinal fluid (CSF) of HAM/TSP patients contained the viral transactivator protein Tax. Additionally, EVs derived from HTLV-1-infected cells (HTLV-1 EVs) promote functional effects such as cell aggregation which enhance viral spread. In this review, we present current knowledge surrounding EVs and their potential role as immune-modulating agents in cancer and other infectious diseases such as HTLV-1 and HIV-1. We discuss various features of EVs that make them prime targets for possible vehicles of future diagnostics and therapies.
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Affiliation(s)
| | | | | | | | | | | | | | - Fatah Kashanchi
- Laboratory of Molecular Virology, George Mason University, Manassas, VA 20110, USA; (S.A.S.); (D.O.P.); (G.A.M.); (F.D.); (P.K.); (Y.K.); (H.B.)
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nazari Z, Ghaffari J, Ghaffari N. Prevalence of Human T Lymphotropic Virus Type 1 in Pregnant Women: a Narrative Review. MEDICAL LABORATORY JOURNAL 2020. [DOI: 10.29252/mlj.14.3.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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14
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Neurological Aspects of HIV-1/HTLV-1 and HIV-1/HTLV-2 Coinfection. Pathogens 2020; 9:pathogens9040250. [PMID: 32231144 PMCID: PMC7238008 DOI: 10.3390/pathogens9040250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/15/2020] [Accepted: 03/27/2020] [Indexed: 02/06/2023] Open
Abstract
Simultaneous infection by human immunodeficiency viruses (HIV) and human T-lymphotropic viruses (HTLV) are not uncommon since they have similar means of transmission and are simultaneously endemic in many populations. Besides causing severe immune dysfunction, these viruses are neuropathogenic and can cause neurological diseases through direct and indirect mechanisms. Many pieces of evidence at present show that coinfection may alter the natural history of general and, more specifically, neurological disorders through different mechanisms. In this review, we summarize the current evidence on the influence of coinfection on the progression and outcome of neurological complications of HTLV-1/2 and HIV-1.
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15
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Pinto DO, DeMarino C, Pleet ML, Cowen M, Branscome H, Al Sharif S, Jones J, Dutartre H, Lepene B, Liotta LA, Mahieux R, Kashanchi F. HTLV-1 Extracellular Vesicles Promote Cell-to-Cell Contact. Front Microbiol 2019; 10:2147. [PMID: 31620104 PMCID: PMC6759572 DOI: 10.3389/fmicb.2019.02147] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 08/30/2019] [Indexed: 12/21/2022] Open
Abstract
Human T-cell leukemia virus-1 (HTLV-1) is a neglected and incurable retrovirus estimated to infect 5 to 10 million worldwide. Specific indigenous Australian populations report infection rates of more than 40%, suggesting a potential evolution of the virus with global implications. HTLV-1 causes adult T-cell leukemia/lymphoma (ATLL), and a neurological disease named HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Even though HTLV-1 transmission primarily occurs from cell-to-cell, there is still a gap of knowledge regarding the mechanisms of viral spread and disease progression. We have recently shown that Extracellular Vesicles (EVs) ubiquitously produced by cells may be used by HTLV-1 to transport viral proteins and RNA, and elicit adverse effects on recipient uninfected cells. The viral proteins Tax and HBZ are involved in disease progression and impairment of autophagy in infected cells. Here, we show that activation of HTLV-1 via ionizing radiation (IR) causes a significant increase of intracellular Tax, but not EV-associated Tax. Also, lower density EVs from HTLV-1-infected cells, separated by an Iodixanol density gradient, are positive for gp61+++/Tax+++/HBZ+ proteins (HTLV-1 EVs). We found that HTLV-1 EVs are not infectious when tested in multiple cell lines. However, these EVs promote cell-to-cell contact of uninfected cells, a phenotype which was enhanced with IR, potentially promoting viral spread. We treated humanized NOG mice with HTLV-1 EVs prior to infection and observed an increase in viral RNA synthesis in mice compared to control (EVs from uninfected cells). Proviral DNA levels were also quantified in blood, lung, spleen, liver, and brain post-treatment with HTLV-1 EVs, and we observed a consistent increase in viral DNA levels across all tissues, especially the brain. Finally, we show direct implications of EVs in viral spread and disease progression and suggest a two-step model of infection including the release of EVs from donor cells and recruitment of recipient cells as well as an increase in recipient cell-to-cell contact promoting viral spread.
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Affiliation(s)
- Daniel O. Pinto
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Catherine DeMarino
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Michelle L. Pleet
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Maria Cowen
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Heather Branscome
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Sarah Al Sharif
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Jennifer Jones
- Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Helene Dutartre
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111-Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
| | | | - Lance A. Liotta
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, United States
| | - Renaud Mahieux
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111-Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
| | - Fatah Kashanchi
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
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Martinez Cuesta L, Nieto Farias MV, Lendez PA, Rowland RRR, Sheahan MA, Cheuquepán Valenzuela FA, Marin MS, Dolcini G, Ceriani MC. Effect of bovine leukemia virus on bovine mammary epithelial cells. Virus Res 2019; 271:197678. [PMID: 31381943 DOI: 10.1016/j.virusres.2019.197678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 12/20/2022]
Abstract
Bovine leukemia virus (BLV) is a retrovirus that infects cattle and is associated with an increase in secondary infections. The objective of this study was to analyze the effect of BLV infection on cell viability, apoptosis and morphology of a bovine mammary epithelial cell line (MAC-T), as well as Toll like receptors (TLR) and cytokine mRNA expression. Our findings show that BLV infection causes late syncytium formation, a decrease in cell viability, downregulation of the anti-apoptotic gene Bcl-2, and an increase in TLR9 mRNA expression. Moreover, we analyzed how this stably infected cell line respond to the exposure to Staphylococcus aureus (S. aureus), a pathogen known to cause chronic mastitis. In the presence of S. aureus, MAC-T BLV cells had decreased viability and decreased Bcl-2 and TLR2 mRNA expression. The results suggest that mammary epithelial cells infected with BLV have altered the apoptotic and immune pathways, probably affecting their response to bacteria and favoring the development of mastitis.
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Affiliation(s)
- Lucia Martinez Cuesta
- Laboratorio de Virología, Centro de Investigación Veterinaria de Tandil (CIVETAN, CONICET-CICPBA), Facultad de Cs. Veterinarias, UNCPBA, Pinto 399, Tandil (7000) Pcia., Buenos Aires, Argentina; Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA.
| | - Maria Victoria Nieto Farias
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, C1033AAJ Buenos Aires, Argentina
| | - Pamela A Lendez
- Laboratorio de Virología, Centro de Investigación Veterinaria de Tandil (CIVETAN, CONICET-CICPBA), Facultad de Cs. Veterinarias, UNCPBA, Pinto 399, Tandil (7000) Pcia., Buenos Aires, Argentina
| | - Raymond R R Rowland
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Maureen A Sheahan
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Felipe A Cheuquepán Valenzuela
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, C1033AAJ Buenos Aires, Argentina; Área de Producción Animal, Estación Experimental Agropecuaria Balcarce, Instituto Nacional de Tecnología Agropecuaria (INTA), Ruta Nacional 226 Km 73.5 (7620), Balcarce, Buenos Aires, Argentina
| | - Maia S Marin
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, C1033AAJ Buenos Aires, Argentina; Área de Producción Animal, Estación Experimental Agropecuaria Balcarce, Instituto Nacional de Tecnología Agropecuaria (INTA), Ruta Nacional 226 Km 73.5 (7620), Balcarce, Buenos Aires, Argentina
| | - Guillermina Dolcini
- Laboratorio de Virología, Centro de Investigación Veterinaria de Tandil (CIVETAN, CONICET-CICPBA), Facultad de Cs. Veterinarias, UNCPBA, Pinto 399, Tandil (7000) Pcia., Buenos Aires, Argentina
| | - Maria Carolina Ceriani
- Laboratorio de Virología, Centro de Investigación Veterinaria de Tandil (CIVETAN, CONICET-CICPBA), Facultad de Cs. Veterinarias, UNCPBA, Pinto 399, Tandil (7000) Pcia., Buenos Aires, Argentina.
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Sodré Barmpas DB, Monteiro DLM, Taquette SR, Rodrigues NCP, Trajano AJB, Cunha JDC, Nunes CL, Villela LHC, Teixeira SAM, Sztajnbok DCDN, Bóia MN. Pregnancy outcomes and mother-to-child transmission rate in HTLV-1/2 infected women attending two public hospitals in the metropolitan area of Rio de Janeiro. PLoS Negl Trop Dis 2019; 13:e0007404. [PMID: 31181057 PMCID: PMC6586357 DOI: 10.1371/journal.pntd.0007404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 06/20/2019] [Accepted: 04/22/2019] [Indexed: 11/30/2022] Open
Abstract
HTLV-1/2 are transmitted sexually, by whole cell blood products and from mother-to-child (MTC), mainly through breastfeeding. HTLV-1/2 prevalence in pregnant women is high in Rio de Janeiro, however there were no local studies addressing the rate of adverse pregnancy outcomes (APO) and MTC transmission. The aim was to study sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in HTLV-1/2-positive women. The cross-sectional study screened 1,628 pregnant women in of Rio de Janeiro (2012–2014) and found 12 asymptomatic carrier mothers (prevalence = 0.74%). Pregnancy outcome information was retrieved from medical records. Sociodemographic characteristics were similar between the positive and negative groups except for maternal age, which was higher in carrier mothers. The incidence of adverse pregnancy outcomes was similar in infected and non-infected patients (p = 0.33), however there was a high rate of premature rupture of membranes (PROM) amid infected mothers (3/12). Multilevel logistic regression found that for each additional year of age, the chance of being HTLV-1/2-positive increased 11% and that having another sexually transmitted infection (STI) increased 9 times the chance of being infected. Carrier mothers had more antenatal visits (OR = 5.26). Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. After two years of follow-up there was one case of MTC transmission (1/9). The mother reported breastfeeding for one month only. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy outcomes and the MTC transmission rate is important to guide public health policies on antenatal screening and management. HTLV-1/2 are retroviruses transmitted by sex, blood products and from mother to child (MTC), mainly through breastfeeding. There is currently no vaccine, treatment or cure. Although it’s mostly asymptomatic it can cause disabling and even lethal diseases in carriers. The prevalence of HTLV-1/2 in pregnant women at the metropolitan area of Rio de Janeiro is high (0.74%). Our aim was to study the sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in the infected population. Apart from being slightly older, there were no differences in the carrier mothers’ sociodemographic profile. Pregnant women with sexually transmitted infections had a 9-fold chance of being HTLV-1/2 positive. Although adverse pregnancy outcomes were not increased, infected mothers had a high rate of ruptured membranes. Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. There was one case of MTC transmission (1/9), after one month of breastfeeding. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy, and the MTC transmission rate is important to guide further research and public health policies.
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Affiliation(s)
| | - Denise Leite Maia Monteiro
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Gynecology and Obstetrics, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, RJ, Brazil
| | - Stella Regina Taquette
- Department of Internal Medicine, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Nádia Cristina Pinheiro Rodrigues
- Department of Epidemiology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Epidemiology, Escola Nacional de Saúde Pública (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Alexandre José Baptista Trajano
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Gynecology and Obstetrics, Universidade Unigranrio, Rio de Janeiro, RJ, Brazil
| | - Juliana de Castro Cunha
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Camila Lattanzi Nunes
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Sérgio A. M. Teixeira
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Márcio Neves Bóia
- Department of Epidemiology, Escola Nacional de Saúde Pública (Fiocruz), Rio de Janeiro, RJ, Brazil
- Department of Infectology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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Rodríguez-Zúñiga M, Cortez-Franco F, Qujiano-Gomero E. Adult T-Cell Leukemia/Lymphoma. Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Harhaj EW, Giam CZ. NF-κB signaling mechanisms in HTLV-1-induced adult T-cell leukemia/lymphoma. FEBS J 2018; 285:3324-3336. [PMID: 29722927 DOI: 10.1111/febs.14492] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/12/2018] [Accepted: 04/26/2018] [Indexed: 12/27/2022]
Abstract
The human T-cell leukemia virus type 1 (HTLV-1) is a complex deltaretrovirus linked to adult T-cell leukemia/lymphoma (ATLL), a fatal CD4 + malignancy in 3-5% of infected individuals. The HTLV-1 Tax regulatory protein plays indispensable roles in regulating viral gene expression and activating cellular signaling pathways that drive the proliferation and clonal expansion of T cells bearing HTLV-1 proviral integrations. Tax is a potent activator of NF-κB, a key signaling pathway that is essential for the survival and proliferation of HTLV-1-infected T cells. However, constitutive NF-κB activation by Tax also triggers a senescence response, suggesting the possibility that only T cells capable of overcoming NF-κB-induced senescence can selectively undergo clonal expansion after HTLV-1 infection. Tax expression is often silenced in the majority of ATLL due to genetic alterations in the tax gene or DNA hypermethylation of the 5'-LTR. Despite the loss of Tax, NF-κB activation remains persistently activated in ATLL due to somatic mutations in genes in the T/B-cell receptor (T/BCR) and NF-κB signaling pathways. In this review, we focus on the key events driving Tax-dependent and -independent mechanisms of NF-κB activation during the multistep process leading to ATLL.
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Affiliation(s)
- Edward William Harhaj
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chou-Zen Giam
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA
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20
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Pirayeshfard L, Sharifi Z, Amini-Kafiabad S, Haghnazari Sadaghiani N. Phylogenetic analysis of HTLV-1 in Iranian blood donors, HIV-1 positive patients and patients with beta thalassemia. J Med Virol 2018; 90:1398-1405. [PMID: 29663494 DOI: 10.1002/jmv.25192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 04/05/2018] [Indexed: 11/06/2022]
Abstract
Human T-cell lymphoma virus (HTLV) has been associated with various disease types. Since the discovery of the virus in 1980, seven subtypes of the virus have been identified. HTLV is widespread and endemic in some regions, such as Japan, Africa, South America, and northeast Iran. This study aimed to identify HTLV-1 genotype and also to analyze the nucleotide sequence of the LTR region in three groups, including blood donors, HIV-1+ patients, and β-thalassemia patients. In this cross-sectional study, 2200 samples were collected from blood donors in Tehran (2000 samples), HIV-1+ patients (100 samples) and β-thalassemia patients (100 samples). All samples were screened for anti-HTLV-I&II antibodies by ELISA. Then, genomic DNA was extracted from repeatedly positive samples, and nested PCR was performed for both the TAX and LTR regions. Purified PCR products were sequenced and analyzed, and finally, a phylogenetic tree was constructed using Mega7 software. The prevalence of the anti-HTLV-I&II antibody among blood donors and HIV-1+ patients was 1.7% (34/2000) and 12% (12/100), respectively. The PCR results confirmed that 0.05% (1/2000) of blood donors, 5% (5/100) of HIV-1+ patients, and 8% (8/100) of β-thalassemia patients were HTLV-I positive. All sequences were matched to HTLV-1 subtype a, subgroup A. Our phylogenetic analysis revealed that all sequenced samples belong to the endemic clusters of Iran. HTLV-1 genotypes in all samples were similar in three groups and were derived from the strains, which had been previously reported from Iran (AF00300/Mashhad and KT190712.1/Sabzevar).
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Affiliation(s)
- Leila Pirayeshfard
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Zohreh Sharifi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Sedigheh Amini-Kafiabad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Nasrin Haghnazari Sadaghiani
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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21
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Rodríguez-Zúñiga MJM, Cortez-Franco F, Qujiano-Gomero E. Adult T-Cell Leukemia/Lymphoma. Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:399-407. [PMID: 29685460 DOI: 10.1016/j.ad.2017.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 12/11/2022] Open
Abstract
Adult T-cell Leukemia/Lymphoma (ATLL) is an aggressive neoplasm of T lymphocytes associated with Human T-lymphotropic virus type1 (HTLV-1) infection. HTLV-1 is a public health problem because it is endemic in native groups in Latin America, and its infection leads to several chronic diseases as ATLL. We aimed to review current literature of ATLL in order to consider it as a differential diagnosis in front of patients with compatible symptoms. Prognosis is still poor in aggressive and indolent variants, with survival rates from months to few years. Treatment based on chemotherapy, antiretroviral, and allogenic stem cell transplantation are currently improving survival rates, but with limited results.
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Affiliation(s)
- M J M Rodríguez-Zúñiga
- Servicio de Dermatología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú; Universidad Nacional Mayor de San Marcos, Lima, Perú.
| | - F Cortez-Franco
- Servicio de Dermatología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú
| | - E Qujiano-Gomero
- Servicio de Dermatología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú
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22
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Sajiki Y, Konnai S, Nishimori A, Okagawa T, Maekawa N, Goto S, Nagano M, Kohara J, Kitano N, Takahashi T, Tajima M, Mekata H, Horii Y, Murata S, Ohashi K. Intrauterine infection with bovine leukemia virus in pregnant dam with high viral load. J Vet Med Sci 2017; 79:2036-2039. [PMID: 29109356 PMCID: PMC5745186 DOI: 10.1292/jvms.17-0391] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Enzootic bovine leukemia is caused by the bovine leukemia virus (BLV). BLV is transmitted vertically or horizontally through the transfer of infected cells via direct contact, through milk, insect bites and contaminated iatrogenic procedures. However, we lacked direct evidence of intrauterine infection. The purpose of this study was to confirm intrauterine BLV infection in two pregnant dams with high viral load by cesarean delivery. BLV was detected in cord and placental blood, and the BLV in the newborns showed 100% nucleotide identity with the BLV-env sequence from the dams. Notably, a newborn was seropositive for BLV but had no colostral antibodies. In this study, we presented a direct evidence of intrauterine BLV transmission in pregnant dam with a high proviral load. These results could aid the development of BLV control measures targeting viral load.
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Affiliation(s)
- Yamato Sajiki
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Satoru Konnai
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Asami Nishimori
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Tomohiro Okagawa
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Naoya Maekawa
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Shinya Goto
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Masashi Nagano
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Junko Kohara
- Animal Research Center, Agricultural Research Department, Hokkaido Research Organization, Shintoku, Hokkaido 081-0038, Japan
| | - Nana Kitano
- Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | | | - Motoshi Tajima
- Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | - Hirohisa Mekata
- Organization for Promotion of Tenure Track, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan.,Center for Animal Disease Control, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan
| | - Yoichiro Horii
- Center for Animal Disease Control, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan
| | - Shiro Murata
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Kazuhiko Ohashi
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
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23
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Farmanbar A, Firouzi S, Makałowski W, Iwanaga M, Uchimaru K, Utsunomiya A, Watanabe T, Nakai K. Inferring clonal structure in HTLV-1-infected individuals: towards bridging the gap between analysis and visualization. Hum Genomics 2017; 11:15. [PMID: 28697807 PMCID: PMC5505134 DOI: 10.1186/s40246-017-0112-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 07/05/2017] [Indexed: 12/12/2022] Open
Abstract
Background Human T cell leukemia virus type 1 (HTLV-1) causes adult T cell leukemia (ATL) in a proportion of infected individuals after a long latency period. Development of ATL is a multistep clonal process that can be investigated by monitoring the clonal expansion of HTLV-1-infected cells by isolation of provirus integration sites. The clonal composition (size, number, and combinations of clones) during the latency period in a given infected individual has not been clearly elucidated. Methods We used high-throughput sequencing technology coupled with a tag system for isolating integration sites and measuring clone sizes from 60 clinical samples. We assessed the role of clonality and clone size dynamics in ATL onset by modeling data from high-throughput monitoring of HTLV-1 integration sites using single- and multiple-time-point samples. Results From four size categories analyzed, we found that big clones (B; 513–2048 infected cells) and very big clones (VB; >2048 infected cells) had prognostic value. No sample harbored two or more VB clones or three or more B clones. We examined the role of clone size, clone combination, and the number of integration sites in the prognosis of infected individuals. We found a moderate reverse correlation between the total number of clones and the size of the largest clone. We devised a data-driven model that allows intuitive representation of clonal composition. Conclusions This integration site-based clonality tree model represents the complexity of clonality and provides a global view of clonality data that facilitates the analysis, interpretation, understanding, and visualization of the behavior of clones on inter- and intra-individual scales. It is fully data-driven, intuitively depicts the clonality patterns of HTLV-1-infected individuals and can assist in early risk assessment of ATL onset by reflecting the prognosis of infected individuals. This model should assist in assimilating information on clonal composition and understanding clonal expansion in HTLV-1-infected individuals. Electronic supplementary material The online version of this article (doi:10.1186/s40246-017-0112-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amir Farmanbar
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwanoha, Kashiwa-shi, Chiba, Japan.,Laboratory of Functional Analysis in silico, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Sanaz Firouzi
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwanoha, Kashiwa-shi, Chiba, Japan.
| | - Wojciech Makałowski
- Institute of Bioinformatics, Faculty of Medicine, University of Muenster, Muenster, Germany
| | - Masako Iwanaga
- Department of Frontier Life Science, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kaoru Uchimaru
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwanoha, Kashiwa-shi, Chiba, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Toshiki Watanabe
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwanoha, Kashiwa-shi, Chiba, Japan.,Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine, Kanagawa, Japan
| | - Kenta Nakai
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwanoha, Kashiwa-shi, Chiba, Japan. .,Laboratory of Functional Analysis in silico, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
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24
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Clonality of HTLV-1-infected T cells as a risk indicator for development and progression of adult T-cell leukemia. Blood Adv 2017; 1:1195-1205. [PMID: 29296760 DOI: 10.1182/bloodadvances.2017005900] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/16/2017] [Indexed: 11/20/2022] Open
Abstract
Adult T-cell leukemia (ATL) is an aggressive T-cell malignancy caused by human T-cell leukemia virus type 1 (HTLV-1) that develops along a carcinogenic process involving 5 or more genetic events in infected cells. The lifetime incidence of ATL among HTLV-1-infected individuals is approximately 5%. Although epidemiologic studies have revealed risk factors for ATL, the molecular mechanisms that determine the fates of carriers remain unclear. A better understanding of clonal composition and related longitudinal dynamics would clarify the process of ATL leukemogenesis and provide insights into the mechanisms underlying the proliferation of a malignant clone. Genomic DNA samples and clinical information were obtained from individuals enrolled in the Joint Study for Predisposing Factors for ATL Development, a Japanese prospective cohort study. Forty-seven longitudinal samples from 20 individuals (9 asymptomatic carriers and 11 patients with ATL at enrollment) were subjected to a clonality analysis. A method based on next-generation sequencing was used to characterize clones on the basis of integration sites. Relationships were analyzed among clonal patterns, clone sizes, and clinical status, including ATL onset and progression. Among carriers, those exhibiting an oligoclonal or monoclonal pattern with largely expanded clones subsequently progressed to ATL. All indolent patients who progressed to acute-type ATL exhibited monoclonal expansion. In both situations, the major expanded clone after progression was derived from the largest pre-existing clone. This study has provided the first detailed information regarding the dynamics of HTLV-1-infected T-cell clones and collectively suggests that the clonality of HTLV-1-infected cells could be a useful predictive marker of ATL onset and progression.
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25
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Ireland G, Croxford S, Tosswill J, Raghu R, Davison K, Hewitt P, Simmons R, Taylor G. Human T-lymphotropic viruses (HTLV) in England and Wales, 2004 to 2013: testing and diagnoses. Euro Surveill 2017. [PMID: 28598325 PMCID: PMC5479983 DOI: 10.2807/1560-7917.es.2017.22.21.30539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Human T-lymphotropic virus (HTLV) infection has been under enhanced surveillance in England and Wales since 2002, however, little is known about testing patterns. Using data from two surveillance systems held at Public Health England, we described HTLV antibody testing patterns between 2008 and 2013 and the demographic and clinical characteristics of persons diagnosed with HTLV in England and Wales between 2004 and 2013. An increase in HTLV testing was observed in England between 2008 and 2013 (3,581 to 7,130). Most tests (82%; 7,597/9,302) occurred within secondary care, 0.5% (48/9,302) of persons were reactive for HTLV antibodies and 0.3% (27/9,302) were confirmed positive. Increasing age and female sex were predictors of a reactive HTLV screen and confirmed diagnosis. Testing in primary care including sexual health and antenatal services was infrequent. Between 2004 and 2013, 858 people were diagnosed with HTLV, most of whom were female (65%; 549/851), of black Caribbean ethnicity (60%), not born in the United Kingdom (72%; 369/514) and asymptomatic at diagnosis (45%; 267/595). Despite increased testing, the epidemiology and clinical features of those diagnosed with HTLV have remained consistent. Apart from donor screening, testing for HTLV infection remains uncommon, except to diagnose associated disease.
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Affiliation(s)
- Georgina Ireland
- National Infection Service, Public Health England, London, United Kingdom
| | - Sara Croxford
- National Infection Service, Public Health England, London, United Kingdom
| | - Jennifer Tosswill
- National Infection Service, Public Health England, London, United Kingdom
| | - Rajani Raghu
- National Infection Service, Public Health England, London, United Kingdom
| | - Katy Davison
- National Infection Service, Public Health England, London, United Kingdom
| | - Patricia Hewitt
- Microbiology Services, NHS Blood and Transplant, London, United Kingdom
| | - Ruth Simmons
- National Infection Service, Public Health England, London, United Kingdom
| | - Graham Taylor
- Section of Virology, Imperial College London, London, United Kingdom
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26
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Ireland G, Croxford S, Tosswill J, Raghu R, Davison K, Hewitt P, Simmons R, Taylor G. Human T-lymphotropic viruses (HTLV) in England and Wales, 2004 to 2013: testing and diagnoses. Euro Surveill 2017; 22:30539. [PMID: 28598325 PMCID: PMC5479983 DOI: 10.2807/1560-7917.es.2017.22.20.30539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/02/2017] [Indexed: 11/20/2022] Open
Abstract
Human T-lymphotropic virus (HTLV) infection has been under enhanced surveillance in England and Wales since 2002, however, little is known about testing patterns. Using data from two surveillance systems held at Public Health England, we described HTLV antibody testing patterns between 2008 and 2013 and the demographic and clinical characteristics of persons diagnosed with HTLV in England and Wales between 2004 and 2013. An increase in HTLV testing was observed in England between 2008 and 2013 (3,581 to 7,130). Most tests (82%; 7,597/9,302) occurred within secondary care, 0.5% (48/9,302) of persons were reactive for HTLV antibodies and 0.3% (27/9,302) were confirmed positive. Increasing age and female sex were predictors of a reactive HTLV screen and confirmed diagnosis. Testing in primary care including sexual health and antenatal services was infrequent. Between 2004 and 2013, 858 people were diagnosed with HTLV, most of whom were female (65%; 549/851), of black Caribbean ethnicity (60%), not born in the United Kingdom (72%; 369/514) and asymptomatic at diagnosis (45%; 267/595). Despite increased testing, the epidemiology and clinical features of those diagnosed with HTLV have remained consistent. Apart from donor screening, testing for HTLV infection remains uncommon, except to diagnose associated disease.
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Affiliation(s)
- Georgina Ireland
- National Infection Service, Public Health England, London, United Kingdom
| | - Sara Croxford
- National Infection Service, Public Health England, London, United Kingdom
| | - Jennifer Tosswill
- National Infection Service, Public Health England, London, United Kingdom
| | - Rajani Raghu
- National Infection Service, Public Health England, London, United Kingdom
| | - Katy Davison
- National Infection Service, Public Health England, London, United Kingdom
| | - Patricia Hewitt
- Microbiology Services, NHS Blood and Transplant, London, United Kingdom
| | - Ruth Simmons
- National Infection Service, Public Health England, London, United Kingdom
| | - Graham Taylor
- Section of Virology, Imperial College London, London, United Kingdom
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27
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Rodríguez-Zúñiga MJM, Cortez-Franco F, Qujiano-Gomero E. Adult T-cell leukemia/lymphoma in a Peruvian hospital in human T-lymphotropic virus type 1 (HTLV-1) positive patients. Int J Dermatol 2017; 56:503-509. [DOI: 10.1111/ijd.13567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/02/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Milton José Max Rodríguez-Zúñiga
- Dermatology Department; Hospital Nacional Daniel Alcides Carrion; Callao Peru
- Universidad Nacional Mayor de San Marcos; Lima Peru
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28
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Farmanbar A, Firouzi S, Park SJ, Nakai K, Uchimaru K, Watanabe T. Multidisciplinary insight into clonal expansion of HTLV-1-infected cells in adult T-cell leukemia via modeling by deterministic finite automata coupled with high-throughput sequencing. BMC Med Genomics 2017; 10:4. [PMID: 28137248 PMCID: PMC5282739 DOI: 10.1186/s12920-016-0241-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 12/22/2016] [Indexed: 12/31/2022] Open
Abstract
Background Clonal expansion of leukemic cells leads to onset of adult T-cell leukemia (ATL), an aggressive lymphoid malignancy with a very poor prognosis. Infection with human T-cell leukemia virus type-1 (HTLV-1) is the direct cause of ATL onset, and integration of HTLV-1 into the human genome is essential for clonal expansion of leukemic cells. Therefore, monitoring clonal expansion of HTLV-1–infected cells via isolation of integration sites assists in analyzing infected individuals from early infection to the final stage of ATL development. However, because of the complex nature of clonal expansion, the underlying mechanisms have yet to be clarified. Combining computational/mathematical modeling with experimental and clinical data of integration site–based clonality analysis derived from next generation sequencing technologies provides an appropriate strategy to achieve a better understanding of ATL development. Methods As a comprehensively interdisciplinary project, this study combined three main aspects: wet laboratory experiments, in silico analysis and empirical modeling. Results We analyzed clinical samples from HTLV-1–infected individuals with a broad range of proviral loads using a high-throughput methodology that enables isolation of HTLV-1 integration sites and accurate measurement of the size of infected clones. We categorized clones into four size groups, “very small”, “small”, “big”, and “very big”, based on the patterns of clonal growth and observed clone sizes. We propose an empirical formal model based on deterministic finite state automata (DFA) analysis of real clinical samples to illustrate patterns of clonal expansion. Conclusions Through the developed model, we have translated biological data of clonal expansion into the formal language of mathematics and represented the observed clonality data with DFA. Our data suggest that combining experimental data (absolute size of clones) with DFA can describe the clonality status of patients. This kind of modeling provides a basic understanding as well as a unique perspective for clarifying the mechanisms of clonal expansion in ATL. Electronic supplementary material The online version of this article (doi:10.1186/s12920-016-0241-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amir Farmanbar
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan.,Laboratory of Functional Analysis in silico, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Sanaz Firouzi
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan.
| | - Sung-Joon Park
- Laboratory of Functional Analysis in silico, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kenta Nakai
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan.,Laboratory of Functional Analysis in silico, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kaoru Uchimaru
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan.,Hematology/Oncology, Research Hospital, Institute of Medical Sciences, The University of Tokyo, Tokyo, Japan
| | - Toshiki Watanabe
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan. .,Department of Advanced Medical Innovation, St. Marianna University School of Medicine, Kanagawa, Japan.
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29
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The evolution of sex-specific virulence in infectious diseases. Nat Commun 2016; 7:13849. [PMID: 27959327 PMCID: PMC5159935 DOI: 10.1038/ncomms13849] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 11/04/2016] [Indexed: 12/11/2022] Open
Abstract
Fatality rates of infectious diseases are often higher in men than women. Although this difference is often attributed to a stronger immune response in women, we show that differences in the transmission routes that the sexes provide can result in evolution favouring pathogens with sex-specific virulence. Because women can transmit pathogens during pregnancy, birth or breast-feeding, pathogens adapt, evolving lower virulence in women. This can resolve the long-standing puzzle on progression from Human T-cell Lymphotropic Virus Type 1 (HTLV-1) infection to lethal Adult T-cell Leukaemia (ATL); a progression that is more likely in Japanese men than women, while it is equally likely in Caribbean women and men. We argue that breastfeeding, being more prolonged in Japan than in the Caribbean, may have driven the difference in virulence between the two populations. Our finding signifies the importance of investigating the differences in genetic expression profile of pathogens in males and females. Many infectious diseases are more likely to progress to serious illness or death in men than in women, which has been attributed to a stronger immune response in women. Here, the authors propose that pathogen transmission from mother to child favours the evolution of lower virulence in women, and argue that the higher risk of HTLV-1 infection progressing to leukaemia in Japanese men is due to prolonged breastfeeding in Japan.
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30
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Seroprevalence of human T-lymphotropic virus in blood bank donors at Fundación Valle del Lili, Cali, Colombia, 2008-2014. BIOMEDICA 2016; 36:108-15. [PMID: 27622800 DOI: 10.7705/biomedica.v36i0.2942] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/23/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Human lymphotropic virus (HTLV I/II) is a retrovirus that is prevalent across the Colombian Pacific coast, and is potentially transmissible by transfusion. Blood bank screening has been regulated since 2004, in order to reduce transmission of HTLV I/II through donation. Information on the seroprevalence of the virus in southwestern Colombia is limited. OBJECTIVE To determine the seroprevalence and the behavior of reactivity to HTLV I/II before and after the introduction of Western blot, and the comorbidity of HTLV and other infectious markers in donors from a blood bank in Cali, Colombia. MATERIALS AND METHODS We conducted a cross-sectional study of 77,117 blood bank donors from the Fundación Valle del Lili by analyzing records of donors who had been tested with the reactive test for anti-HTLV I-II antibodies (IgG) between January, 2008, and December, 2014. RESULTS The cumulative seroprevalence during the study period was 0.24% (186/77,119). Reactivity was more common in women (61%), and the median age was 37 years (IQR: 24-48). The seroprevalence in the years before the introduction of Western blot was 0.13%, 0.19%, 0.31%, 0.32% and 0.18% (2008-2012), and thereafter it was 0.08% and 0.07% (2012-2014). Concomitant reactivity with other infectious markers was 11%: syphilis (57%), followed by HIV (19%), hepatitis B (14%) and hepatitis C (9%). The highest seroprevalence (0.38%) was reported in 2012. CONCLUSION We found a high prevalence of reactivity to HTLV I-II compared to that reported in other studies. The results of this study are a starting point for the development of population studies.
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31
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Paiva A, Casseb J. Sexual transmission of human T-cell lymphotropic virus type 1. Rev Soc Bras Med Trop 2014; 47:265-74. [PMID: 25075475 DOI: 10.1590/0037-8682-0232-2013] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/17/2014] [Indexed: 11/22/2022] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in many parts of the world and is primarily transmitted through sexual intercourse or from mother to child. Sexual transmission occurs more efficiently from men to women than women to men and might be enhanced by sexually transmitted diseases that cause ulcers and result in mucosal ruptures, such as syphilis, herpes simplex type 2 (HSV-2), and chancroid. Other sexually transmitted diseases might result in the recruitment of inflammatory cells and could increase the risk of HTLV-1 acquisition and transmission. Additionally, factors that are associated with higher transmission risks include the presence of antibodies against the viral oncoprotein Tax (anti-Tax), a higher proviral load in peripheral blood lymphocytes, and increased cervicovaginal or seminal secretions. Seminal fluid has been reported to increase HTLV replication and transmission, whereas male circumcision and neutralizing antibodies might have a protective effect. Recently, free virions were discovered in plasma, which reveals a possible new mode of HTLV replication. It is unclear how this discovery might affect the routes of HTLV transmission, particularly sexual transmission, because HTLV transmission rates are significantly higher from men to women than women to men.
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Affiliation(s)
- Arthur Paiva
- Laboratório de Investigação em Dermatologia e Imunodeficiência, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jorge Casseb
- Laboratório de Investigação em Dermatologia e Imunodeficiência, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
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Monteiro DLM, Taquette SR, Sodré Barmpas DB, Rodrigues NCP, Teixeira SAM, Villela LHC, Bóia MN, Trajano AJB. Prevalence of HTLV-1/2 in pregnant women living in the metropolitan area of Rio de Janeiro. PLoS Negl Trop Dis 2014; 8:e3146. [PMID: 25188386 PMCID: PMC4154655 DOI: 10.1371/journal.pntd.0003146] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022] Open
Abstract
Background HTLV-1/2 infection can cause severe and disabling diseases in children and adults. The aim of the study was to estimate the prevalence of HTLV-1/2 infection in pregnant women living in the metropolitan area of Rio de Janeiro. Methodology/Principal Findings 1,204 pregnant women were tested upon hospital admission for delivery in two public hospitals in the cities of Rio de Janeiro and Mesquita, between November, 2012 and April, 2013. The samples were screened by chemiluminescent microparticle immunoassay (CMIA) and reactive ones were confirmed by Western blot (WB). Epi-info software was used for building the database and performing the statistical analysis. Eight patients had confirmed HTLV-1/2 infection (7 HTLV-1, one HTLV-2), equivalent to a prevalence rate of 0.66%. Two further reactive screening tests had negative Western blot results and therefore were considered negative in the statistical analysis. All HTLV-1/2-positive patients were born in Rio de Janeiro, most were non-Caucasian (87.5%), in a stable relationship (62.5%), had at least ten years of formal education (62.5%) and a monthly family income of up to US$600.00 (87.5%). There was only one case of coinfection with syphilis and none with HIV. The mean age of the infected women was 28.4 (SD = 6.3) years and of the seronegative ones was 24.8 (SD = 6.5) (p = 0.10). The median number of pregnancies were 3.0 and 1.0 (p = 0.06) and the median number of sexual partners were 3.5 and 3.0 (p = 0.33) in the seropositive and negative groups, respectively. There were no statistically significant differences between the groups. Conclusions/Significance A significant prevalence of HTLV-1/2 was found in our population. The socio-epidemiological profile of carrier mothers was similar to the controls. Such findings expose the need for a public health policy of routine HTLV-1/2 screening in antenatal care, since counselling and preventive measures are the only strategies currently available to interrupt the chain of transmission and the future development of HTLV-1/2-related diseases. HTLV-1/2 are retroviruses transmitted by blood products, sexual contact and from mother to child, mainly through breastfeeding. The infection has a characteristic geographical distribution with endemic areas often neighbouring very low prevalence areas. Infection is life long and although asymptomatic in most cases, it can cause severe and disabling diseases in children and adults. There is currently no cure, vaccine or effective treatment for HTLV-1/2 infections. Our research is the first to study the prevalence of HTLV-1/2 in pregnant women living in the metropolitan area of Rio de Janeiro, the second largest in Brazil. 1,204 pregnant women were tested upon hospital admission for delivery in two public hospitals in the cities of Rio de Janeiro and Mesquita, between November, 2012 and April, 2013 and a significant prevalence of HTLV-1/2 was found (0.66%). The socio-epidemiological profile of carrier mothers was similar to the controls'. Epidemiological knowledge is fundamental for the elaboration of public health policies such as routine HTLV-1/2 screening in antenatal care, since counselling and preventive measures, mainly avoidance of breastfeeding, are the only strategies currently available to interrupt the chain of transmission and the future development of HTLV-1/2-related diseases.
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Affiliation(s)
- Denise Leite Maia Monteiro
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Rio de Janeiro, Brazil
| | | | | | - Nádia Cristina P Rodrigues
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sérgio A M Teixeira
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Hospital Estadual da Mãe - Mesquita, Rio de Janeiro, Brazil
| | | | - Márcio Neves Bóia
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexandre José Baptista Trajano
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil; Universidade do Grande Rio (UNIGRANRIO), Duque de Caxias, Rio de Janeiro, Brazil
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Carneiro-Proietti ABF, Amaranto-Damasio MS, Leal-Horiguchi CF, Bastos RHC, Seabra-Freitas G, Borowiak DR, Ribeiro MA, Proietti FA, Ferreira ASD, Martins ML. Mother-to-Child Transmission of Human T-Cell Lymphotropic Viruses-1/2: What We Know, and What Are the Gaps in Understanding and Preventing This Route of Infection. J Pediatric Infect Dis Soc 2014; 3 Suppl 1:S24-9. [PMID: 25232474 PMCID: PMC4164183 DOI: 10.1093/jpids/piu070] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/14/2014] [Indexed: 01/03/2023]
Abstract
Although human T-cell lymphotropic viruses (HTLV-1/2) were described over 30 years ago, they are relatively unknown to the public and even to healthcare personnel. Although HTLV-1 is associated with severe illnesses, these occur in only approximately 10% of infected individuals, which may explain the lack of public knowledge about them. However, cohort studies are showing that a myriad of other disease manifestations may trouble infected individuals and cause higher expenditures with healthcare. Testing donated blood for HTLV-1/2 started soon after reliable tests were developed, but unfortunately testing is not available for women during prenatal care. Vertical transmission can occur before or after birth of the child. Before birth, it occurs transplacentally or by transfer of virus during cesarean delivery, but these routes of infection are rare. After childbirth, viral transmission occurs during breastfeeding and increases with longer breastfeeding and high maternal proviral load. Unlike the human immunodeficiency virus types 1 and 2, HTLV is transmitted primarily through breastfeeding and not transplacentally or during delivery. In this study, we review what is currently known about HTLV maternal transmission, its prevention, and the gaps still present in the understanding of this process.
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Affiliation(s)
- A B F Carneiro-Proietti
- Interdisciplinary HTLV Research Group Fundação Hemominas Faculdade da Saúde e Ecologia Humana
| | | | - C F Leal-Horiguchi
- Interdisciplinary HTLV Research Group Fundação Hemominas Faculdade da Saúde e Ecologia Humana
| | - R H C Bastos
- Interdisciplinary HTLV Research Group Faculdade da Saúde e Ecologia Humana
| | - G Seabra-Freitas
- Interdisciplinary HTLV Research Group Faculdade da Saúde e Ecologia Humana
| | - D R Borowiak
- Interdisciplinary HTLV Research Group Faculdade da Saúde e Ecologia Humana
| | - M A Ribeiro
- Interdisciplinary HTLV Research Group Fundação Hemominas Fundação Hospitalar do Estado de Minas Gerais
| | - F A Proietti
- Interdisciplinary HTLV Research Group Faculdade da Saúde e Ecologia Humana Laboratório de Epidemiologia e Antropologia Médica, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Minas Gerais, Brazil
| | - A S D Ferreira
- Interdisciplinary HTLV Research Group Fundação Hemominas
| | - M L Martins
- Interdisciplinary HTLV Research Group Fundação Hemominas Faculdade da Saúde e Ecologia Humana
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Hlela C, Bittencourt A. Infective dermatitis associated with HTLV-1 mimics common eczemas in children and may be a prelude to severe systemic diseases. Dermatol Clin 2014; 32:237-48. [PMID: 24680009 DOI: 10.1016/j.det.2013.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Infective dermatitis associated with human T-cell lymphotropic virus type 1 (HTLV-1) (IDH) is a chronic dermatitis that has been observed in a variable proportion of HTLV-1-infected children. IDH may serve as an early clinical marker for HTLV-1 infection and an indicator of increased risk for developing other HTLV-1-associated conditions. Factors that lead only some infected children to develop IDH are poorly understood. The variable clinical presentation of IDH, in particular its chronicity, the morphology and distribution of the lesions, and its clinical resemblance to other cutaneous inflammatory conditions, make it necessary to distinguish it from other common dermatoses.
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Affiliation(s)
- Carol Hlela
- Division of Dermatology, Red Cross War Memorial Children's Hospital, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, Western Cape 7700, South Africa.
| | - Achiléa Bittencourt
- Laboratory Service, Complexo Hospitalar Universita'rio Prof Edgars Santos, University of Bahia, Rua Augusto Viana, s/n-Canela-40110-160 Salvador, Bahia, Brazil
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Yoshimitsu M, White Y, Arima N. Prevention of human T-cell lymphotropic virus type 1 infection and adult T-cell leukemia/lymphoma. Recent Results Cancer Res 2014; 193:211-25. [PMID: 24008301 DOI: 10.1007/978-3-642-38965-8_12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive peripheral T-cell malignancy that develops after long-term chronic infection with human T-cell lymphotropic virus type-1 (HTLV-1). Despite the recent advances in chemotherapy, allogeneic hematopoietic stem cell transplantation (alloHSCT), and supportive care, the prognosis for patients with ATL is one of the poorest among hematological malignancies; overall survival (OS) at 3 years is only 24 % in the more aggressive subtypes of ATLL. HTLV-1 is a human retrovirus infecting approximately 10-20 million people worldwide, particularly in southern and southeastern Japan, the Caribbean, highlands of South America, Melanesia, and Equatorial Africa. Despite this high frequency of human infection, only 2-5 % of HTLV-1-infected individuals develop ATLL. Three major routes of viral transmission have been established: (1) mother-to-child transmission through breast-feeding; (2) sexual transmission, predominantly from men to women; and (3) cellular blood components. Multiple factors (e.g., virus, host cell, and immune factors) have been implicated in the development of ATLL, although the underlying mechanisms of leukemogenesis have not been fully elucidated. No preventive vaccine against HTLV-1 is currently available, and interrupting the well-recognized primary modes of HTLV-1 transmission is the mainstay of ATLL prevention. Prevention of mother-to-child transmission through the replacement of breast-feeding has been shown to have the most significant impact on the incidence of HTLV-1 infection, and public health policies should consider the risk of malnutrition, especially in developing countries where malnutrition is the significant cause of infant mortality.
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Affiliation(s)
- Makoto Yoshimitsu
- Department of Hematology and Immunology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan,
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Blocking vertical transmission of human T cell lymphotropic virus type 1 and 2 through breastfeeding interruption. Pediatr Infect Dis J 2012; 31:1139-43. [PMID: 22683674 DOI: 10.1097/inf.0b013e318263215e] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) causes serious diseases and is endemic in many parts of the world. It is transmitted from mother to child in 15-25% of the cases, primarily through breastfeeding. Proviral load and duration of breastfeeding are thought to play a role in transmission. This study aimed to detect HTLV-seropositive mothers through testing of neonates, to evaluate maternal HTLV proviral load and to measure the rates of transmission blocking when interruption of breastfeeding was implemented. METHODS Neonates were screened for HTLV-1/2 IgG by enzyme immunoassay using the neonatal screening program of Minas Gerais State, Brazil. Breastfeeding interruption was recommended to those whose mothers were confirmed HTLV-positive. Children were tested by polymerase chain reaction at birth and at 12 months of age. RESULTS Of 55,293 neonates tested, 42 (0.076%) were positive for HTLV-1 or HTLV-2 IgG. All 42 were polymerase chain reaction-negative at birth and 1 of 37 (2.7%) became antibody-positive after 12 months. His mother had delivered him vaginally and was informed of the positive HTLV-1 polymerase chain reaction after 7 days of breastfeeding. The mother's proviral load was 271 copies/10,000 cells, whereas the average is 109.2 copies/10,000 cells (95% confidence interval: 70.56-147.83). CONCLUSIONS Maternal HTLV-1 proviral load and the route of delivery may have played a role in the transmission observed. Avoidance of breastfeeding was an effective measure to reduce HTLV transmission. In endemic countries, routine prenatal or neonatal screening combined with formula feeding for mothers confirmed HTLV-positive may be an important strategy to prevent future development of illnesses related to HTLV.
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Malm K, Ekermo B, Hillgren K, Britton S, Fredlund H, Andersson S. Prevalence of human T-lymphotropic virus type 1 and 2 infection in Sweden. ACTA ACUST UNITED AC 2012; 44:852-9. [DOI: 10.3109/00365548.2012.689847] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Transcytosis of HTLV-1 across a tight human epithelial barrier and infection of subepithelial dendritic cells. Blood 2012; 120:572-80. [PMID: 22589473 DOI: 10.1182/blood-2011-08-374637] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia/lymphoma and HTLV-1-associated myelopathy/tropical spastic paraparesis. In addition to blood transfusion and sexual transmission, HTLV-1 is transmitted mainly through prolonged breastfeeding, and such infection represents a major risk for the development of adult T-cell leukemia/lymphoma. Although HTLV-1-infected lymphocytes can be retrieved from maternal milk, the mechanisms of HTLV-1 transmission through the digestive tract remain unknown. In the present study, we assessed HTLV-1 transport across the epithelial barrier using an in vitro model. Our results show that the integrity of the epithelial barrier was maintained during coculture with HTLV-1-infected lymphocytes, because neither morphological nor functional alterations of the cell monolayer were observed. Enterocytes were not susceptible to HTLV-1 infection, but free infectious HTLV-1 virions could cross the epithelial barrier via a transcytosis mechanism. Such virions were able to infect productively human dendritic cells located beneath the epithelial barrier. Our data indicate that HTLV-1 crosses the tight epithelial barrier without disruption or infection of the epithelium to further infect target cells such as dendritic cells. The present study provides the first data pertaining to the mode of HTLV-1 transport across a tight epithelial barrier, as can occur during mother-to-child HTLV-1 transmission during breastfeeding.
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Inagaki S, Takahashi M, Fukunaga Y, Takahashi H. HTLV-I-infected breast milk macrophages inhibit monocyte differentiation to dendritic cells. Viral Immunol 2012; 25:106-16. [PMID: 22356642 DOI: 10.1089/vim.2011.0069] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Human T-cell leukemia virus type I (HTLV-I), a causative agent of adult T-cell leukemia (ATL), is transmitted from mother to child, predominantly by breastfeeding. Oral HTLV-I infection and infection early in life are associated with a subsequent risk of ATL. Although the pathogenic mechanisms of ATL remain largely unknown, the host immune system seems to play an important role in HTLV-I pathogenesis. Previous studies have shown that monocytes from ATL patients had reduced capacity for dendritic cell (DC) differentiation. Therefore, we performed the present study to clarify the mechanisms responsible for the impairment of DC differentiation using HTLV-I-infected breast milk macrophages (HTLV-BrMMø). We found that when CD14⁺ monocytes were cultured with GM-CSF and IL-4 in the presence of HTLV-BrMMø, they altered the surface phenotype of immature DCs and the stimulatory capacity of T-cell proliferation. The presence of HTLV-BrMMø significantly blocked the increased expression of CD1a, CD1b, CD11b, DC-SIGN, and HLA-DR; however, increased expression of CD1d and CD86 was observed. These effects could be partially replicated by incubation with culture supernatants from HTLV-BrMMø. The impairment of monocyte differentiation might be not due to HTLV-I infection of monocytes, but might be due to unknown soluble factors. Since other HTLV-I-infected cells exhibited similar inhibitory effects on monocyte differentiation to DCs, we speculated that HTLV-I infection might cause the production of some inhibitory cytokines in infected cells. Identifying the factors responsible for the impairment of monocyte differentiation to DCs may be helpful to understand HTLV-I pathogenesis.
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Affiliation(s)
- Shinichiro Inagaki
- Departments of Microbiology and Immunology, Nippon Medical School, Tokyo, Japan
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Hino S. Establishment of the milk-borne transmission as a key factor for the peculiar endemicity of human T-lymphotropic virus type 1 (HTLV-1): the ATL Prevention Program Nagasaki. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2011; 87:152-66. [PMID: 21558754 PMCID: PMC3149377 DOI: 10.2183/pjab.87.152] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 02/24/2011] [Indexed: 05/13/2023]
Abstract
In late 2010, the nation-wide screening of pregnant women for human T-lymphotropic virus type 1 (HTLV-1) infection was implemented in Japan to prevent milk-borne transmission of HTLV-1. In the late 1970s, recognition of the adult T-cell leukemia (ATL) cluster in Kyushu, Japan, led to the discovery of the first human retrovirus, HTLV-1. In 1980, we started to investigate mother-to-child transmission (MTCT) for explaining the peculiar endemicity of HTLV-1. Retrospective and prospective epidemiological data revealed the MTCT rate at ∼20%. Cell-mediated transmission of HTLV-1 without prenatal infection suggested a possibility of milk-borne transmission. Common marmosets were successfully infected by oral inoculation of HTLV-1 harboring cells. A prefecture-wide intervention study to refrain from breast-feeding by carrier mothers, the ATL Prevention Program Nagasaki, was commenced in July 1987. It revealed a marked reduction of HTLV-1 MTCT by complete bottle-feeding from 20.3% to 2.5%, and a significantly higher risk of short-term breast-feeding (<6 months) than bottle-feeding (7.4% vs. 2.5%, P < 0.001).
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Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev 2010; 23:577-89. [PMID: 20610824 DOI: 10.1128/cmr.00063-09] [Citation(s) in RCA: 300] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1), the first human retrovirus to be discovered, is present in diverse regions of the world, where its infection is usually neglected in health care settings and by public health authorities. Since it is usually asymptomatic in the beginning of the infection and disease typically manifests later in life, silent transmission occurs, which is associated with sexual relations, breastfeeding, and blood transfusions. There are no prospects of vaccines, and screening of blood banks and in prenatal care settings is not universal. Therefore, its transmission is active in many areas such as parts of Africa, South and Central America, the Caribbean region, Asia, and Melanesia. It causes serious diseases in humans, including adult T-cell leukemia/lymphoma (ATL) and an incapacitating neurological disease (HTLV-associated myelopathy/tropical spastic paraparesis [HAM/TSP]) besides other afflictions such as uveitis, rheumatic syndromes, and predisposition to helminthic and bacterial infections, among others. These diseases are not curable as yet, and current treatments as well as new perspectives are discussed in the present review.
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The HTLV-1 Virological Synapse. Viruses 2010; 2:1427-1447. [PMID: 21994688 PMCID: PMC3185711 DOI: 10.3390/v2071427] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 06/04/2010] [Accepted: 06/29/2010] [Indexed: 01/05/2023] Open
Abstract
Human T-lymphotropic virus-1 (HTLV-1) spreads efficiently between T-cells via a tight and highly organized cell-cell contact known as the virological synapse. It is now thought that many retroviruses and other viruses spread via a virological synapse, which may be defined as a virus-induced, specialized area of cell-to-cell contact that promotes the directed transmission of the virus between cells. We summarize here the mechanisms leading to the formation of the HTLV-1 virological synapse and the role played by HTLV-1 Tax protein. We propose a model of HTLV-1 transmission between T-cells based on the three-dimensional ultrastructure of the virological synapse. Finally, in the light of recent advances, we discuss the possible routes of HTLV-1 spread across the virological synapse.
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Takeuchi H, Takahashi M, Norose Y, Takeshita T, Fukunaga Y, Takahashi H. Transformation of breast milk macrophages by HTLV-I: implications for HTLV-I transmission via breastfeeding. ACTA ACUST UNITED AC 2010; 31:53-61. [PMID: 20203420 DOI: 10.2220/biomedres.31.53] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Human T cell leukemia virus type I (HTLV-I), a causative agent of adult T-cell leukemia (ATL), is transmitted from mother to child predominantly by breastfeeding. The source of HTLV-I-infected cells in breast milk has been thought to be T cells, however, the majority of cells in breast milk are CD14(+) macrophages but not CD3(+) T lymphocytes, and no data are available regarding HTLV-I transmission through breast milk macrophages (BrMMpsi). To explore the potential of BrMMpsi as a possible source of infection in mother to child transmission (MTCT) of HTLV-I, an immortalized cell line (HTLV-BrMMpsi) has been established from BrMMpsi by infection with HTLV-I. HTLV-BrMMpsi retained macrophage characteristics and did not express a complete dendritic cell (DC) phenotype; nevertheless, HTLV-BrMMpsi efficiently promoted T cell proliferation in primary allogeneic mixed lymphocyte reaction (MLR) like DC. Moreover, HTLV-I infection could be transmitted from HTLV-BrMMpsi to activated T cells in the peripheral blood. These findings suggested that BrMMpsi might be an appropriate HTLV-I reservoir involved in MTCT transmission via breastfeeding.
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Affiliation(s)
- Hodaka Takeuchi
- Department of Microbiology and Immunology, Nippon Medical School, Tokyo, Japan
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Cockrill T, del Junco DJ, Arnett FC, Assassi S, Tan FK, McNearney T, Fischbach M, Perry M, Mayes MD. Separate influences of birth order and gravidity/parity on the development of systemic sclerosis. Arthritis Care Res (Hoboken) 2010; 62:418-24. [PMID: 20391489 DOI: 10.1002/acr.20096] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Birth order has been valuable in revealing the role of environmental influences on the risk of developing certain diseases such as allergy and atopy. In addition, pregnancy has profound effects on the immune system such as short-term effects that permit fetal survival as well as longer-term effects that could influence late-onset diseases. In order to better evaluate these influences, we studied the association of birth order and gravidity/parity as risk factors for systemic sclerosis (SSc; scleroderma). METHODS Data regarding SSc cases and their unaffected sibling controls were obtained from the Scleroderma Family Registry and DNA Repository. The case-sibling design was used to minimize confounding due to differences in age, race, ethnicity, or calendar time. The gravidity/parity analysis was based on sibships with at least one SSc-affected and one unaffected sister. RESULTS Birth order was examined in 974 sibships, comparing SSc cases (n = 987) with their unaffected siblings (n = 3,088). The risk of scleroderma increased with increasing birth order (odds ratio [OR] 1.25, 95% confidence interval [95% CI] 1.06-1.50 for birth order 2-5; OR 2.22, 95% CI 1.57-3.15 for birth order 6-9; and OR 3.53, 95% CI 1.68-7.45 for birth order 10-15). Gravidity/parity was analyzed in 168 sibships (256 unaffected sisters, 172 SSc cases). We found an association between a history of one or more pregnancies and SSc (OR 2.8). CONCLUSION Birth order and pregnancy were independently associated with a higher risk of developing SSc. These findings suggest that immune development in early childhood and/or pregnancy-associated events, including but not limited to microchimerism, plays a role in SSc susceptibility.
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Affiliation(s)
- Tonya Cockrill
- University of Texas Health Science Center at Houston, TX 77030, USA
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Nascimento LBD, Carneiro MADS, Teles SA, Lopes CLR, Reis NRDS, Silva AMDCE, Motta-Castro ARC, Otsuki K, Vicente ACP, Martins RMB. [Prevalence of infection due to HTLV-1 in remnant quilombos in Central Brazil]. Rev Soc Bras Med Trop 2010; 42:657-60. [PMID: 20209350 DOI: 10.1590/s0037-86822009000600009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 10/27/2009] [Indexed: 11/21/2022] Open
Abstract
This study aimed to determine the prevalence of HTLV-1 infection among remnant black quilombo communities in Central Brazil. A total of 1,837 individuals were evaluated, among whom nine were HTLV-1/2 seropositive according to ELISA. All of them were positive for HTLV-1 by means of Western blot and/or PCR, thus resulting in a prevalence of 0.5% (95% CI: 0.2-1.0). The HTLV-1 infected individuals ranged in age from 11 to 82 years. The majority of them were females. Regarding risk characteristics, histories of breastfeeding, blood transfusion, multiple sexual partners and sexually transmitted diseases were reported by these individuals. The findings from this study indicate the importance of identifying HTLV-1 infected individuals, as a strategy for infection control and prevention in these remnant quilombos.
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Abstract
The molecular and genetic factors induced by human T-lymphotropic virus type-1 (HTLV-1) that initiate adult T-cell leukemia/lymphoma (ATLL) remain unclear, in part from the lack of an animal model that accurately recapitulates leukemogenesis. HTLV-1-infected humanized nonobese diabetic severe combined immunodeficiency (HU-NOD/SCID) mice were generated by inoculation of NOD/SCID mice with CD34(+) hematopoietic progenitor and stem cells (CD34(+) HP/HSCs) infected ex vivo with HTLV-1. HTLV-1-HU-NOD/SCID mice exclusively developed CD4(+) T-cell lymphomas with characteristics similar to ATLL and elevated proliferation of infected human stem cells (CD34(+)CD38(-)) in the bone marrow were observed in mice developing malignancies. Purified CD34(+) HP/HSCs from HTLV-1-infected patient peripheral blood mononuclear cells revealed proviral integrations suggesting viral infection of human bone marrow-derived stem cells. NOD/SCID mice reconstituted with CD34(+) HP/HSCs transduced with a lentivirus vector expressing the HTLV-1 oncoprotein (Tax1) also developed CD4(+) lymphomas. The recapitulation of a CD4(+) T-cell lymphoma in HU-NOD/SCID mice suggests that HSCs provide a viral reservoir in vivo and act as cellular targets for cell transformation in humans. This animal model of ATLL will provide an important tool for the identification of molecular and cellular events that control the initiation and progression of the lymphoma and potential therapeutic targets to block tumor development.
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48
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Kendall EA, González E, Espinoza I, Tipismana M, Verdonck K, Clark D, Vermund SH, Gotuzzo E. Early neurologic abnormalities associated with human T-cell lymphotropic virus type 1 infection in a cohort of Peruvian children. J Pediatr 2009; 155:700-6. [PMID: 19628219 PMCID: PMC2764792 DOI: 10.1016/j.jpeds.2009.05.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 02/25/2009] [Accepted: 05/19/2009] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Because human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may occur in some children infected with HTLV-1, we sought to determine the prevalence of neurologic abnormalities and any associations of neurologic abnormalities with infective dermatitis in these children. STUDY DESIGN We enrolled 58 children infected with HTLV-1 and 42 uninfected children (ages 3 to 17) of mothers infected with HTLV-1 in a family study in Lima, Peru. We obtained medical and developmental histories, surveyed current neurologic symptoms, and conducted a standardized neurologic examination without prior knowledge of HTLV-1 status. RESULTS HTLV-1 infection was associated with reported symptoms of lower extremity weakness/fatigue (odds ratio [OR], 6.1; confidence interval [CI], 0.7 to 281), lumbar pain (OR, 1.7; 95% CI, 0.4 to 8), and paresthesia/dysesthesia (OR, 2.6; CI, 0.6 to 15.8). HTLV-1 infection was associated with lower-extremity hyperreflexia (OR, 3.1; CI, 0.8 to 14.2), ankle clonus (OR, 5.0; CI, 1.0 to 48.3), and extensor plantar reflex (OR undefined; P = .2). Among children infected with HTLV-1, a history of infective dermatitis was associated with weakness (OR, 2.7; CI, 0.3 to 33), lumbar pain (OR, 1.3; CI, 0.2 to 8), paresthesia/dysesthesia (OR, 2.9; CI, 0.5 to 20), and urinary disturbances (OR, 5.7; CI, 0.5 to 290). CONCLUSIONS Abnormal neurologic findings were common in Peruvian children infected with HTLV-1, and several findings were co-prevalent with infective dermatitis. Pediatricians should monitor children infected with HTLV-1 for neurologic abnormalities.
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Affiliation(s)
- Emily A. Kendall
- Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Elsa González
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia
| | - Iván Espinoza
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia;,Department of Pediatrics. Hospital Nacional Cayetano Heredia
| | - Martín Tipismana
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia;,Neurology Service. Hospital Nacional Cayetano Heredia
| | - Kristien Verdonck
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia;,Laboratorios de Investigación y Desarrollo (LID), Facultad de Ciencias y Filosofía; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Daniel Clark
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia;,Virology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sten H. Vermund
- Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia;,Department of Infectious, Tropical and Dermatological Diseases. Hospital Nacional Cayetano Heredia
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49
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Proietti FA, Carneiro-Proietti ABF, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-I infection and associated diseases. Oncogene 2005; 24:6058-68. [PMID: 16155612 DOI: 10.1038/sj.onc.1208968] [Citation(s) in RCA: 642] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Epidemiologic aspects of human T-lymphotropic virus type I (HTLV-I) infection have been thoroughly studied over the course of approximately 25 years since its first description. The geographic distribution of the virus has been defined, with Japan, Africa, Caribbean islands and South America emerging as the areas of highest prevalence. The reasons for HTLV-I clustering, such as the high ubiquity in southwestern Japan but low prevalence in neighboring regions of Korea, China and eastern Russia are still unknown. The major modes of transmission are well understood, although better quantitative data on the incidence of transmission, and on promoting/inhibiting factors, are needed. Epidemiologic proof has been obtained for HTLV-I's causative role in major disease associations: adult T-cell leukemia (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV-associated uveitis and infective dermatitis. However, more and better studies are needed for other apparent disease outcomes such as rheumatologic, psychiatric and infectious diseases. Since curative treatment of ATL and HAM/TSP is lacking and a vaccine is unavailable, the social and financial cost for the individual, his/her family and the health system is immense. For this reason, public health interventions aimed at counseling and educating high-risk individuals and populations are of paramount importance.
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Affiliation(s)
- Fernando A Proietti
- Department of Social and Preventive Medicine, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil.
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50
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Goldman AS, Goldman LR, Goldman DA. What caused the epidemic of Pneumocystis pneumonia in European premature infants in the mid-20th century? Pediatrics 2005; 115:e725-36. [PMID: 15867015 DOI: 10.1542/peds.2004-2157] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
An epidemic of interstitial pneumonia principally involving premature infants occurred in Germany and nearby European countries between the 1920s and 1960s. Fatalities were due to Pneumocystis. Because the principal defenses against Pneumocystis are T cells, an acquired T-cell deficiency was postulated. A number of potential causes including malnutrition were considered. All were implausible except for a retrovirus that was benign in adults but virulent in premature infants. Furthermore, we suspect that the virus was imported into Germany from former German African colonies. Premature infants were vulnerable because of the developmental status of their T cells. Given the practices in that part of Europe at that time, the virus was most likely transmitted by contaminated blood transfusions and subsequent contamination of reusable needles and syringes used in injections. Although the epidemic ended 4 decades ago, a search for the postulated retrovirus can be conducted if tissues from affected infants are available.
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MESH Headings
- Blood Transfusion/instrumentation
- Cameroon/ethnology
- Cytomegalovirus Infections/complications
- Cytomegalovirus Infections/transmission
- Disease Outbreaks/history
- Disease Susceptibility
- Emigration and Immigration
- Equipment Contamination
- Europe/epidemiology
- Female
- Germany/epidemiology
- History, 20th Century
- Humans
- Immunity, Cellular
- Immunologic Deficiency Syndromes/ethnology
- Immunologic Deficiency Syndromes/etiology
- Immunologic Deficiency Syndromes/history
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/history
- Infant, Premature, Diseases/immunology
- Lung Diseases, Interstitial/epidemiology
- Lung Diseases, Interstitial/etiology
- Lung Diseases, Interstitial/history
- Lung Diseases, Interstitial/immunology
- Lung Diseases, Interstitial/microbiology
- Male
- Malnutrition/complications
- Malnutrition/epidemiology
- Milk, Human/cytology
- Milk, Human/virology
- Pneumonia, Pneumocystis/epidemiology
- Pneumonia, Pneumocystis/history
- Pneumonia, Pneumocystis/immunology
- Pregnancy
- Pregnancy Complications, Infectious/epidemiology
- Retroviridae Infections/complications
- Retroviridae Infections/epidemiology
- Retroviridae Infections/ethnology
- Retroviridae Infections/history
- Retroviridae Infections/immunology
- Retroviridae Infections/transmission
- Togo/ethnology
- Transfusion Reaction
- Travel
- Virulence
- Warfare
- Xenobiotics/adverse effects
- Zinc/deficiency
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Affiliation(s)
- Armond S Goldman
- University of Texas Medical Branch, Galveston, TX 77555-0369, USA.
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